Objective To observe the application effect of Clampcath trocar in immune adsorption.Methods A tatol of 40 patients underwent immune adsorption in our hospital were divided into the observation group and the control group according to the random number table method,with 20 cases in each group.In the observation group,20 cases were treated with Clampcath trocar as temporary vascular access for immune adsorption,and in the control group,20 cases were treated with 16 G indwelling needle as temporary vascular access for immune adsorption.The blood flow,tube plugging rate,discount rate,indwelling time of immune adsorption of patients in each group were compared.Results The tube blocking rate and discount rate of the observation group were significantly lower than that of the control group (P＜0.05),the difference wasstatistically significant;in the observation group,the blood flow was significantly higher than that in the control group (P＜ 0.01),the indwelling time of the observation group was longer than that of the control group (P＜0.05),the difference was statistically significant.Conclusion Clampcath trocar could be used as temporary vascular access for immune adsorption,of which the operation is simple,and is cheap and affordable.Meanwhile,it has advantages include low tube plugging rate and discount rate,long indwelling time and sufficient blood flow,thus it could alleviate the suffering of patients and reduce the waste of resources,and it's worthy of clinical promotion.

Objective To discuss the treatment mode of mass NBC casualties by field medical unit in NBC environment.Method Field medical unit rehearsed in a simulated NBC environment.Result The procedure for the rehearsal and treatment of field medical unit in NBC environment was determined.The importance of high-tech medical equipment for the obstructed patient flow was made clear.Conclusion High-tech medical equipment should be emphasized on to enhance the treatment capability of field medical unit.

Dendritic cells (DCs) are professional antigen presenting cells of the immune system. They can be generated in vitro from peripheral blood monocytes supplemented with GM-CSF, IL-4 and TNF alpha. During induction, DCs will increase in size and acquire multiple cytoplasmic projections when compared to their precursor cells such as monocytes or haematopoietic stem cells which are usually round or spherical. Morphology of DCs can be visualized by conventional light microscopy after staining or phase-contrast inverted microscopy or confocal laser scanning microscopy. In this report, we described the morphological appearances of DCs captured using the above-mentioned techniques. We found that confocal laser scanning microscopy yielded DCs images with greater details but the operating cost for such a technique is high. On the other hand, the images obtained through light microscopy after appropriate staining or phase contrast microscopy were acceptable for identification purpose. Besides, these equipments are readily available in most laboratories and the cost of operation is affordable. Nevertheless, morphological identification is just one of the methods to characterise DCs. Other methods such as phenotypic expression markers and mixed leukocyte reactions are additional tools used in the characterisation of DCs.
Dendritic Cells/*cytology ; Microscopy, Confocal ; Microscopy, Phase-Contrast

Objective To observe the clinical efficacy and adverse reactions of tigecycline in treatment of health-care-associated pneumonia (HAP ) caused by extensively drug-resistant Acinetobacter baumannii (XDRAB ). Methods Clinical data of patients who used tigecycline for the treatment of XDRAB HAP in intensive care units of a hospital from March 2013 to June 2014 were retrospectively analyzed.Results XDRAB isolated from 31 patients with HAP were all sensitive to tigecycline,the resistance rates to carbapenems and sulbactams (including cefopera-zone-sulbactam,SCF)were all 100%,17 cases (54.84%)were mixed infection.Combined use rates of tigecycline and SCF were 85.71 %(12/14)in respiratory intensive care unit(RICU)and 47.06%(8/17)in general intensive care unit(GICU).Of 31 patients,the cure rate,effective rate,bacterial clearance rate,and antimicrobial adverse reac-tion rate were 29.03%,45.16%,61 .29%,and 16.13% respectively,no serious adverse drug reactions occurred. In RICU group and GICU group,the cure rates were 42.86% and 17.65% respectively,effective rates were 71 .43% and 23.53% respectively,and bacterial clearance rates were 78.57 % and 47.06% respectively,difference in effective rate between two groups was significant (P <0.05).Among patients receiving combination of tigecycline and SCF as well as not receiving combined SCF,the cure rates were 35.00% and 18.18% respectively,effective rates were 60.00% and 18.18% respectively,and bacterial clearance rates were 65.00% and 54.55% respectively, difference in effective rate between two groups was significant (P <0.05).Conclusion Tigecycline has a good clini-cal efficacy and little adverse reaction in treating XDRAB HAP;tigecycline combined with SCF is a good choice.

Objective To compare bolus infusion and replenishment using real low mechanical index contrast enhanced ultrasound in assessing the change of renal cortical perfusion.Methods Using dopamine (i.v.) at the dose of 0.5,2.0,5.0μg · kg- 1 · min- 1 to change renal blood perfusion of 20 rabbits,then during bolus or contant injection of SonoVue,at coded pulse inversion mode,real-time contrast ultrasound was performed,the latter method needed destroying microbubble at a high MI when amplitude reach a steady state,then recording the replenishment,peak intensity(A) and time to peak (PPT) were obtained through raw time-intensity curve,and slope rate of TIC(k) was acquired by curve fitting,standard effective renal plasma flow(ERPF) was measured through 4-aminohippuric acid clearancerate method,meanwhile correlations between ERPF and parameters were analyzed,as well as the paired samples t test for each parameter before and after dopamine administration.Results The ascending branchs of raw TIC of bolus infusion increased sharply and were approximately straight,then descended gradually,while that of replenishment looked like two straightlines with different slopes,then stayed horizontal Both the value of A of two methods were positively correlated with ERPF ( r b =0.85,r re =0.66),and were different at the same ERPF,meanwhile the value of TTP were negatively correlated with ERPF( r b =-0.92,r re =- 0.76),and there were no statistically difference between the two methods.k from Gamma fitting was far from correct,while k from exponential fitting was apparently correlated with ERPF ( r re =0.77 ).Conclusions Both bolus injection and constant injection-replenishment method can assess renal cortical blood perfusion,TIC parameters A and TTP represent regional blood volume fraction and microbubble velocity respectively.Bolus-infusion with real low mechanical index is more precise and available.Comparing with k,TTP is more appropriate to reflect perfusion velocity.

Objective To investigate the feasibility of transfecting gene into HepG2 by therapeutic ultrasound combined with microbubble,and to explore the optimal ultrasonic parameters for high transfection efficiency.Methods HepG2 cells were cross-interval planted in 24-well plates.EGFP plasmid DNA and microbubbles were added to the cultured HepG2 and three parameters of the therapeutic ultrasound were optimized.Firstly,set ultrasonic intensity gradient (group A,from A1 to A5),which were 0.4 W/cm,0.8 W/cm2,1.2 W/cm2,1.6 W/cm2 and 2.0 W/cm2 respectively.Secondly,set the duty cycle gradient group (group B,from B1 to B3),which were 10％,20％ and 50％ respectively.Lastly,set the exposure time group(group C,from C1 to C3),which were 30 s,90 s and 180 s.After 24 hours,the expression of GFP was observed by fluorescence microscopy,the transfection rates was detected by flow cytometry,the cell death were assessed by trypan blue exclusion.Results The plasmid transfection efficiency was varied under different ultrasonic parameters.Within a certain range,the increasing of parameters can improve the transfection efficiency,but when the parameters were too large (eg.the intensity＞1.6 W/cm2 or 50％ duty cycle),the actual transfection efficiency decreased due to the increased cell death.When the ultrasonic intensity was 1.2 W/cm2,the transfection efficiency and mortality were better than the other subgroups of group A.When the duty cycle was 20％,the transfection efficiency and mortality rate were better than the other subgroups of group B.Continue to increase the exposure time over 90 s was not statistically significant (P ＞0.05) for transfection efficiency and cell mortality.Conclusions The ultrasound-targeted microbubble destruction is an efficient method for gene delivery in vitro.The transfection efficiency vary greatly under different parameters,so optimization parameters is conducive to the promotion of gene transfection.

Background& Objective: Investigation modalities, such as MRI and CSF examination, are neither sensitive nor specific in the early phase of anti-NMDAR encephalitis. Nuclear imaging may be useful to monitor the response to treatment but limited by the availability.We aimed to determine the role of EEG as a tool for early diagnosis as well as a tool to assess disease progression and response to treatment. Methods: A total of 99 EEGsdone in 16 patients diagnosed with anti-NMDAR encephalitis throughout the course of illness, were reviewed retrospectively. The EEG changes were correlated with the clinical presentations and response to treatment. Sixteen EEGs of patients with schizophrenia and mood disorder, and 10 EEGs of patients with infective encephalitis were included as control. Results: EEGs performed during the psychiatric and cognitive dysfunctionphase in patient with anti-NMDAR encephalitis, showed diffuse background slowing in the delta-theta range in all the patients. Serial EEGs showed that the dominant background frequency improved with improvement in cognitive status. Nine patients had complete recovery with normalisation of the EEG abnormalities. Eight patients had their typical clinical seizure recorded during EEG monitoring, but only 2 (25.0%) with EEG correlation. Ten patients had status epilepticus (62.5%), 5 had EEG recorded during their status epilepticus, of which only one with EEG correlation (20.0%). Eleven patients had asymmetric background (68.8%), but only 1 has correlation with focal changes in the MRI brain (9.1%). Even though the EEGs of patients with infective encephalitis also showed background slowing, their CSF analysis was supportive of an infective cause. EEGs of patients with established psychiatric disorder were within normal limits. Conclusion: EEG abnormality has a good correlation with the degree of psychiatric and cognitive dysfunction in patient with anti-NMDAR encephalitis, and is useful in early diagnosis, monitoring the progress and the response to treatment. However, it has poor correlation with clinical seizures.
Electroencephalography

Adrenal Gland Neoplasms ; metabolism ; pathology ; Aged ; Antigens, CD20 ; analysis ; CD79 Antigens ; analysis ; Humans ; Immunohistochemistry ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Male

0.05)and 1.464(95% CI 1.061- 2.020,P=0.02),respectively in hemorrhagic stroke patients after adjustment for age,gender,ethnieity,cigarette smoking and alcohol drinking.However,the ORs of mortality and morbidity were not significant in various pulse pressure groups in ischemic stroke patients.Conclusion The elevated pulse pressure was associated with increased risk of in-hospital morbidity only in hemorrhagic stroke patients.

Objective:To observe the effects of Shexiang Baoxin Pill (SBP) on isoprenaline (Iso)-induced changes in myocardial cell volume,shape,and connexin 43 (Cx43) expression.Methods:HgC2 myocardial cells were randomly divided into a control group,a Iso group and a Iso+SBP group.After 72 h of culture,the average surface area of HgC2 cells was measured under phase contrast microscope.Bicinchoninic acid (BCA) protein assay was carried out to determine the concentration of proteins.The survival rate of myocardial cells was measured by methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay,and the Cx43 expression was detected by Western blot.Results:The mean surface area and Cx43 concentration in Iso-treated myocardial cells were increased under the phase contrast microscope (P<0.05).Compared with the Iso group,the mean surface area was decreased,and the Cx43 concentration was reduced in the Iso+SBP group (both P<0.05).Compared with the control group,the Cx43 expression was obviously down-regulated in the H9C2 cells of the Iso group (P<0.05);while compared with the Iso group,the Cx43 expression was obviously up-regulated in the Iso+SBP group (P<0.05).Conclusion:Shexiang Baoxin Pills can prevent Iso-induced myocardial hypertrophy and down-regulate Cx43 expression.